Technical Assistance Consultant’s Report - …

1 Technical Assistance consultant s Report Project Number: 37402 May 2009 RETA 6143: Technical Assistance for Promoting Gender Equality and Women's Empowerment (Financed by the Gender and Development Cooperation Fund) Prepared by PRIMEX T his consultant s Report does not necessarily reflect the views of ADB or the Government concerned, and DB and the Government cannot be held liable for its contents. (For project preparatory Technical ssistance: All the views expressed herein may not be incorporated into the proposed project s design. Aa RETA 6143 PROMOTING GENDER EQUALITY AND WOMEN S EMPOWERMENT SUPPORTING WOMEN AT-RISK AND VULNERABLE TO HIV/AIDS Prepared by PRIMEX May 2009 RETA 6143: SUPPORTING WOMEN AT RISK AND VULNERABLE TO HIV/AIDS IN THE PHILIPPINES (Contract No. COSO-080-081) FINAL Report May 2009 RETA 6143: SUPPORTING WOMEN AT RISK AND VULNERABLE TO HIV/AIDS IN THE PHILIPPINES (Contract No.))

2 COSO-080-081) FINAL Report May 2009 PACIFIC RIM INNOVATION AND MANAGEMENT EXPONENTS, INC., PHILIPPINES IN ASSOCIATION WITH AND RETA 6143: SUPPORTING WOMEN AT RISK AND VULNERABLE TO HIV/AIDS IN THE PHILIPPINES (Contract No. COSO-080-081) table OF CONTENTS Page i table OF CONTENTS Page List of Tables ii List of Appendixes ii List of Abbreviations iii Executive Summary v I. INTRODUCTION 1 II. PROJECT DESCRIPTION 2 III. PROJECT ACCOMPLISHMENTS 3 A. Component 1: Female Spouses of Seafarers 3 B. Component 2: Female Seafarers 11 C. Component 3: Female IDUs 15 IV. EVALUATION OF PROJECT DESIGN AND IMPLEMENTATION 21 A. Relevance of Project Design and Formulation 21 B. Project Outputs 21 C. Project Schedule 23 D. Implementation Arrangements 23 E.

3 consultant Recruitment and Procurement 23 F. Performance of the IAs 23 G. Performance of the consultant 23 H. Performance of ADB 23 V. EVALUATION OF PROJECT PERFORMANCE 24 A. Relevance 24 B. Effectiveness in Achieving Outcomes 24 C. Efficiency in Achieving Outputs 25 D. Preliminary Assessment of Sustainability 26 V. LESSONS LEARNED 26 A. Component 1: Female Spouses of Seafarers 26 B. Component 2: Female Filipino Seafarers 27 C. Component 3: Female IDUs 27 VI. RECOMMENDATIONS AND NEXT STEPS 27 A. Component 1: Female Spouses of Seafarers 27 B. Component 2: Female Filipino Seafarers 28 C. Component 3: Female IDUs 29 D. Overall 29 REFERENCES 30 RETA 6143: SUPPORTING WOMEN AT RISK AND VULNERABLE TO HIV/AIDS IN THE PHILIPPINES (Contract No. COSO-080-081) table OF CONTENTS Page ii LIST OF TABLES Number Title Page 1 Information on the Spouses Organizations 4 2 Summary of Training Courses Conducted for Female Spouses of Seafarers 5 3 Knowledge and Skills Gaps Identified through TNA 7 4 consultant s Assessment of Performance Targets and Deliverables 21 5 Coverage of Female Spouses Reached by the Project 23 LIST OF APPENDIXES Number Title 1 Design and Monitoring Framework (DMF) 2 Comprehensive Training Report on the Development of Peer Educators Among Female Spouses of Seafarers 3 Training Evaluation Report of Peer Education Outreach Seminars 4 Review of Existing Behavioral Change Communication (BCC) Material and Identification of HIV Information Needs of Female Spouses of Seafarers 5 Illustrated BCC Material.

4 Pagbangon sa Bagong Umaga: Ang Kwento ng Isang Asawang HIV+ 6 Highlights of the Stakeholders Forum on Establishing A Sexual and Reproductive Health (SRH) Referral Mechanism for Female Spouses of OFWs 7 Sexual and Reproductive Health (SRH) Directory 8 A Qualitative Study of the Personal and Structural Determinants of the Risks and Vulnerabilities of Female Filipino Seafarers to HIV Infection and Other Reproductive Health problems 9 Gender-Specific Vulnerabilities of Females Who Inject Drugs (FIDUs) in Metro Cebu and Zamboanga City 10 Program and Policy Implications of Study on Female Injecting Drugs Users RETA 6143: SUPPORTING WOMEN AT RISK AND VULNERABLE TO HIV/AIDS IN THE PHILIPPINES (Contract No. COSO-080-081) table OF CONTENTS Page iii LIST OF ABBREVIATIONS ACHIEVE Action for Health Initiatives, Inc. ADB Asian Development Bank AIDS acquired immune deficiency syndrome ALAGAD Alliance Against AIDS AMTP AIDS Medium Term Plan BCC behavior change communication BIHMI Brokenshire Integrated Health Ministries.

5 Incorporated BTL bilateral tubal ligation CCSV Craftstruck Club of Seaman s Village CEDAW Convention on the Elimination of All Forms of Discrimination against Women CHD Center for Health Development CHO City Health Office DFR draft final Report DMF design and monitoring framework DMPA depot medroxyprogesterone acetate DOH Department of Health DOLE Department of Labor and Employment FGD focus group discussion FIDU female injecting drug user FR final Report GAD gender and development GDCF Gender and Development Cooperation Fund GO government organization HDES Human Development and Empowerment Services HDII Human Development Initiatives Institute HIV human immunodeficiency virus IDI in-depth interview IDU injecting drug user IHBSS Integrated HIV and AIDS Behavioral and Serologic Surveillance ILO International Labor Organization IMC ILO Maritime Convention KABP knowledge, attitude, behavior, and practices KAP knowledge, attitudes.

6 And practices KII key informant interview LGU local government unit MARP most-at-risk population MHO Municipal Health Office MSSSFA Mary s Star of the Sea Seafarers Families Association NCDPC National Center for Disease Prevention and Control NEC National Epidemiology Center NGO non-government organization NTP notice to proceed OFW overseas Filipino worker PE peer educator PLHIV people living with HIV PNAC Philippine National Aids Council PNGOC Philippine NGO Council on Population, Health and Welfare, Inc.

7 POEA Philippine Overseas Employment Administration RETA 6143: SUPPORTING WOMEN AT RISK AND VULNERABLE TO HIV/AIDS IN THE PHILIPPINES (Contract No. COSO-080-081) table OF CONTENTS Page iv PRIMEX Pacific Rim Innovation and Management Exponents, Inc. RAF Remedios AIDS Foundation RETA regional Technical Assistance RH reproductive health RHU rural health unit SRH sexual and reproductive health STI sexually transmitted infection TNA training needs assessment UNAIDS Joint United Nations Programme on HIV/AIDS VAC Veritas Allottees Circle VAWC Anti-Violence Against Women and Children VCT voluntary counseling and testing WCSV Women s Circle of Seaman s Village WEF Women s Empowerment Framework EXECUTIVE SUMMARY RETA 6143.

8 SUPPORTING WOMEN AT RISK AND VULNERABLE TO HIV/AIDS IN THE PHILIPPINES (Contract No. COSO-080-081) EXECUTIVE SUMMARY Page v EXECUTIVE SUMMARY 1. Subproject 5 of the ADB Regional Technical Assistance for Fighting HIV/AIDS in Asia and the Pacific (RETA 6321) provided Technical Assistance to the Philippine Department of Health (DOH), local government units (LGUs), and non-government organizations (NGOs) to strengthen the country response to HIV/AIDS, specifically for two groups considered vulnerable, viz., injecting drug users (IDUs) (Component 1) and overseas Filipino workers (OFWs) (Component 2). During the implementation of Subproject 5, several gender-related concerns emerged which had to be addressed to strengthen the gender perspective of the Project outputs. 2. In April 2008, ADB approved DOH s request for funding to enable the conduct of studies and other activities under the project, Supporting Women at-Risk and Vulnerable to HIV/AIDS in the Philippines.

9 Funding was provided by ADB through the Gender and Development Cooperation Fund (GDCF) established under RETA 6143, which supports initiatives to promote gender mainstreaming in ADB operations, gender capacity development, and strategic partnerships. 3. The Project was designed to help (i) increase knowledge and awareness of vulnerable women, specifically female spouses of OFWs, on gender, sexual reproductive health (SRH), and HIV prevention in the Project areas, and (ii) develop policy recommendations for female seafarers and FIDUs in the national HIV and AIDS Program. It was expected to deliver the following outputs: (i) improved knowledge and practice of female spouses; (ii) development of a model for SRH referral for female spouses; (iii) increased knowledge and information on HIV vulnerability among female seafarers; and (iv) increased knowledge and information on female IDUs. 4. The Project worked with three groups of women considered vulnerable to HIV and AIDS, namely: female spouses of seafarers, female seafarers, and female IDUs.

10 It was expected to deliver the following outputs: (i) improved knowledge and practice of female spouses of seafarers; (ii) model SRH referral for female spouses of seafarers; (iii) increased knowledge and information on HIV vulnerability among female seafarers; (iv) increased knowledge and information on HIV vulnerability among female IDUs; and (v) Policy Brief on issues concerning FIDUs. The Project s accomplishments per target output are summarized below. 5. Output 1: Improved Knowledge and Practice of Female Spouses of Seafarers. Three spouses groups in Cavite province, Davao City, and Metro Manila participated in weekend capacity building activities designed to train them to serve as peer educators on HIV and AIDS, gender, sexuality, and SRH. The 21 peer educators have reached out to 110 peers: Cavite (65) and Davao (45). Post-test results revealed an increase in the knowledge and awareness of the female spouses on HIV and AIDS.